Cancer of the breast: 5-year survival in a tertiary hospital in Uganda

Cancer of the breast is a major health burden and the most common cancer in women worldwide. It is among the most common causes of cancer death in women in both high-resource and low-resource settings, and is responsible for over 1 million of the estimated 10 million neoplasms diagnosed worldwide each year in both sexes (Ferlay et al, 2001). The incidence in developed countries, for example, the United States and the United Kingdom, is much higher, ranging between 50 and 100 per 100 000 (Althuis et al, 2005), and was responsible for about 375 000 deaths in the United States in 2000 (Bray et al, 2004). Breast cancer is the third most common cancer in women in Uganda after cancer of the cervix and Kaposi's sarcoma (Parkin et al, 1997). Breast cancer incidence in Uganda was 11 : 100 000 in 1961 and had doubled to 22 : 100 000 by 1995 (Wabinga et al, 2000). The incidence in Zimbabwe is 20, in Gambia 4, in South Africa 70 (in whites) and 11 (in blacks) per 100 000 (Vorobiof et al, 2001). African women are diagnosed more often between 35 and 45 years, which is more than 15 years earlier than the women in Europe and North America. The mortality rate in sub-Saharan Africa is disproportionately high compared with the incident rate (Fregene and Newman, 2005). Five-year overall survival rate varies from 86% in Canada (NCIC, 2006) to 88% in the United States (ACS, 2006), whereas it was 80% in whites and 64% in blacks in South Africa (Vorobiof et al, 2001). The main objective of this study was to investigate the 5-year overall survival of breast cancer patients treated at Mulago Hospital, which is a national referral and tertiary centre.